How to Diagnose Eye Cancer

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methods

1Watching for Symptoms

2Performing Medical Tests

3Treating the Cancer

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Expert Q&A

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Because it shares symptoms with many other eye conditions, eye cancer can be tricky to catch and diagnose. You might notice a loss of vision, strange shadows or shapes in your vision, or changes in the color of your eye. Only a medical professional can diagnose eye cancer. If you notice symptoms at home, visit your doctor for a diagnosis. If you do have eye cancer, it is important to get treatment early.

Steps

Method 1

Method 1 of 3:

Watching for Symptoms

1. 
   1
   Monitor any change in your vision. If your vision changes, there may be a condition causing it. These changes may happen suddenly or develop slowly over time.

   • If you suddenly become blind, this is a medical emergency. Call emergency services for immediate help.
2. 
   2
   Look for any floaters or dark spots in your field of vision. Changes in your field of vision can also be symptoms of eye cancer or other conditions. In particular, watch out for:

   • Shadows at the edges or corners of your vision.
   • A dark, growing spot in middle of your vision.
   • Floaters or wiggly lines that glide across your vision.
   • Bright flashes of light.
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3. 
   3
   Inspect the physical condition of your eye. Look in the mirror with both eyes open to check for any changes. Ask someone else for their opinion if you’re uncertain. Some physical changes that need to be evaluated to rule out cancer include:

   • A bulging eye. The eye may appear larger than normal or it may seem swollen.
   • Change in the size of the pupil. The pupil may be either larger or smaller than normal.
   • Change in position of the eye. The eye may be drifting off to one side or you may not be able to control where the eye is pointed.
   • A lump on the eye or eyelid. This could indicate a basal cell carcinoma (or skin cancer) on your lids, which is the most common type of eye cancer.
   • Lesions inside your lids. These may sometimes be mistaken for a chalazion or stye.
   • Change in color of the iris. This may occur in only one part of the eye or only in one eye.
   • Red or inflamed eye. This will usually occur without any pain.
4. 
   4
   Note any light sensitivity in your eye. If you’re more sensitive to light than usual, there may be a medical cause. Light may cause you to flinch or squint. It might also cause discomfort or headaches.

   • If you have pain or sensitivity in your eyes, you may need more tests to identify the problem.
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Method 2

Method 2 of 3:

Performing Medical Tests

1. 
   1
   Visit an eye doctor to see if you have another eye condition. There are many different symptoms that your doctor may consider in their diagnosis. An ophthalmologist can do a number of tests to determine the source of the problem.

   • If you don’t already have an ophthalmologist, ask your primary care physician for a referral.
2. 
   2
   Undergo an eye exam. The doctor will begin with a basic eye exam. They will shine a light into your eyes as they examine your eye. They may ask you to follow an item with your eyes or you might look into a light as they inspect your eye with various tools.

   • In children, the doctor may shine a light to see the color of the reflection. If the reflection is white instead of red, the child may have retinoblastoma.
   • The doctor may use eye drops to enlarge your pupil. They will then use a light and magnifying glass (called an ophthalmoscope) to look into the back of your eye for tumors or growths.
   • The doctor will numb your eyes with some special eye drops before placing a mirrored lens on the surface of your eyes. This will let them see difficult corners of your eye.
3. 
   3
   Order an ultrasound to check for an eye melanoma or retinoblastoma. In this procedure, the doctor will place a wand against your eye. Sound waves will reconstruct the structure of your inner eye.

   • Melanoma develops in the pigment cells of your eye. It is more common in people with light colored eyes.
   • Retinoblastoma is a childhood cancer that affects the retina of the eye. If you are concerned about symptoms your child has been experiencing, take them to see a doctor.
4. 
   4
   Inject dye in your arm to see if you have other types of cancer. This is called fluorescein angiography. The doctor will inject a special orange dye in your arm. They will then use a special camera to take a picture of your eye. The dye will illuminate veins in your eye as well as tumors.

   • Doctors are checking to make sure there are no squamous cell carcinoma and lymphoma. Other conditions may also be detected using this test.
5. 
   5
   Undergo a biopsy if your doctor thinks you have lymphoma. During this procedure, you will receive local anesthesia on your eye or general anesthesia. The doctor will use a thin needle to scrape up cells from the tumor. The doctor will send the cells to a lab to diagnose the cancer.

   • Intraocular lymphoma occurs in the retina, optic nerve, or other area inside of the eye. It is very likely to spread, so your doctor may start treatment immediately.
   • If your doctor thinks you have melanoma, it is very unlikely that you will have a biopsy.
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Method 3

Method 3 of 3:

Treating the Cancer

1. 
   1
   Extract the tumors through surgery. For small, contained tumors, your doctor may simply remove the tumor through surgery. While you may need anesthesia, this procedure usually won't last for longer than a few hours,

   • This may be used for all types of eye cancer, although it is less commonly done for lymphomas.
   • Surgery may be required if you have a diagnosis of cancer.
2. 
   2
   Install a radioactive plaque to shrink melanoma or retinoblastoma. In brachytherapy, you will undergo a short surgery to place a plate (or plaque) with radioactive material on or near the tumor. Keep the plaque on the eye for up to a week. The doctors will remove it with another brief surgery. In 3-6 months, your doctors will check to see if the procedure worked.

   • This treatment has great outcomes for people with melanomas. In most cases, it will remove or shrink tumors without affecting your vision.
   • The operations usually only take 1-2 hours. You can go home the same day. Fortunately, most people won't feel any pain or discomfort from the plaque.
   • Although uncommon, side effects might include cataracts, retinal detachment, glaucoma, or bleeding.
3. 
   3
   Undergo external beam radiation to treat lymphomas. External beam radiation uses radiation from a machine that is pointed towards the tumor. This procedure is usually painless; you may not feel anything as it happens. You may, however, need to go in for daily treatments for several weeks.

   • External beam radiation is sometimes used in combination with surgery. The surgery will remove the tumors while the radiation will prevent the cancer from spreading or returning.
   • There is a chance of developing cataracts, retinal detachment, glaucoma, and bleeding from this procedure. In some cases, there is also a risk of cognitive problems, like trouble concentrating or remembering. Talk to your doctor if you're concerned about side effects.
4. 
   4
   Go through chemotherapy if the cancer has spread. Chemotherapy is more common when treating lymphomas than other types of eye cancer, although it may be used if the cancer has spread. There are a few different ways you might receive chemotherapy.

   • For intraocular lymphoma, the drugs will be injected directly into your eye. The doctor will usually numb your eye first.
5. 
   5
   Remove the eye through surgery if you've lost your vision. If your vision is completely gone or if the tumor has grown too large, your doctors may recommend removal of the eye. They will anesthetize you before removing the eye. An artificial eye will be inserted into your socket 6 weeks after surgery.

   • This procedure is rare, and it usually only happens in severe cases.
   • It can be a difficult decision to remove your eye. Fortunately, artificial eyes look very realistic these days, and most people's vision adjust to having only 1 eye. Family and friends may provide support during this time.
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Expert Q&A

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• Question

  How do you know if you have eye cancer?

  

  Mark Cannon, OD
  Board Certified Optometrist

  Dr. Mark Cannon is an Optometrist and Chief of Optometry at Cannon Eyecare, a family-owned optometry practice in Seattle, Washington. With over 10 years of experience, Dr. Cannon specializes in ocular disease, dry eye, glaucoma, eye infection, contact lens fitting, and pediatrics. Dr. Cannon holds a BS in Biology and Psychology from Indiana University. He received his Doctorate in Optometry from Indiana University School of Optometry, where he earned the Dean's Scholar award and participated in years of ophthalmic research. Dr. Cannon worked as an optometrist for four years before founding Cannon Eyecare, which offers full-scope medical optometry services. Dr. Cannon is a member of the American Optometric Association, King County Optometric Society, and the Optometric Physicians of Washington.

  

  Mark Cannon, OD

  Board Certified Optometrist

  Expert Answer

  This is hard to answer definitively because there are so many different places that cancer can manifest in and on the eyes. The most common type is a basal cell carcinoma (skin cancer) on the lids. There can also be cancerous lesions inside the lids, on the conjunctiva, or in the retina.

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Tips

• Wearing sunglasses can help reduce your risk of getting eye cancer.
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• See your eye doctor once a year for an eye exam, and have dilation done every 5 years. This can help with early detection.
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• Roughly 80% of people who have eye cancer survive 5 years as long as the cancer stays confined to the eye. If the cancer spreads, the survival rate drops depending on where it has spread.
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